非癫痫性发作患者停用抗癫痫药物的安全性。
The safety of antiepileptic drug withdrawal in patients with non-epileptic seizures.
作者信息
Oto M, Espie C, Pelosi A, Selkirk M, Duncan R
机构信息
Southern General Hospital, Institute of Neurological Sciences, 1345 Govan Road, Glasgow G51 4TF, UK.
出版信息
J Neurol Neurosurg Psychiatry. 2005 Dec;76(12):1682-5. doi: 10.1136/jnnp.2005.064063. Epub 2005 Jun 8.
BACKGROUND
To determine whether withdrawal of anticonvulsant drugs (AED) can be carried out safely in patients with non-epileptic seizures (NES).
METHODS
Prospective evaluation of safety and outcome in 78 patients with NES who satisfied a standardised set of criteria for excluding the diagnosis of coexisting or underlying epilepsy.
FINDINGS
The patients were taking from one to three AED. Sixty four patients were withdrawn as outpatients, 14 as inpatients. Five patients stopped their drugs abruptly, and two had AED restarted and had to be withdrawn again. Otherwise all patients adhered to withdrawal schedules. A new type of attack in addition to NES was seen in three patients (complex partial seizures in all three cases). NES frequency declined in the group as a whole over the period of the study (follow up 6-12 months) in all individuals except for eight patients in whom there was a transient increase. Fourteen patients reported new physical symptoms after withdrawal; however, no serious adverse events were reported.
CONCLUSIONS
With appropriate diagnostic investigation and surveillance during follow up withdrawal of AED can be achieved safely in patients with NES.
背景
确定抗惊厥药物（AED）撤药在非癫痫性发作（NES）患者中是否可安全进行。
方法
对78例符合排除并存或潜在癫痫诊断标准集的NES患者进行安全性和转归的前瞻性评估。
结果
患者服用1至3种AED。64例患者作为门诊患者撤药，14例作为住院患者撤药。5例患者突然停药，2例重新启用AED后不得不再次撤药。否则所有患者均遵守撤药计划。3例患者（所有3例均为复杂部分性发作）出现了除NES之外的新型发作。在研究期间（随访6至12个月），除8例患者短暂增加外，整个组中NES频率在所有个体中均下降。14例患者在撤药后报告了新的躯体症状；然而，未报告严重不良事件。
结论
在适当的诊断性检查及随访期间监测下，NES患者可安全停用AED。
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